The WIHS is the largest and longest-duration cohort study of HIV infection in women in the U.S. The San Francisco Bay Area WIHS (SF WIHS) application is focused on continuing our contributions to WIHS: 1. Enrollment and retention of participants (including HIV+ women who are not in care) via a regional consortium and generation of complete and high quality data and specimens, 2. The vigorous participation of site investigators in the WIHS scientific process, and 3. Proposal of new aims that address key issues concerning processes and conditions associated with excess morbidity in HIV+ women in the current treatment era. The new aims feature special emphasis on vascular injury and pain and were selected because they concern key morbidities in potent antiretroviral therapy (cART) treated women, involve sex dimorphic phenomena, and may be influenced by gonadal aging. Vascular measures include indicators of medium (Ankle Brachial Index) and very small vessel condition (measures of retinal vessel caliber). We put forward an increased focus on functional outcomes, including specific organ functional measures, and total physical fitness and morphology (such as kyphosis). The pain studies take the unique approach of assessing what participants mean when they report pain, assess genetic contributions and examine outcomes that include physical function. We also propose to continue our work to measure long term exposure to antiretroviral drugs (ARVs) using hair samples, which are producing high impact reports concerning the pharmacology of ARVs in women and continuation of the WIHS Genetics Unit that was recently established in SF WIHS and is conducting Genome-Wide Association Studies.